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Biomedical subjects

R Alves

Publications and source records attributed to R Alves.

36 records · Page 2Linked to original sources
PubMed1999

Sexual behavior in sleep, sleepwalking and possible REM behavior disorder: a case report.

Seven cases of sexual behavior during sleep (SBS) have been recently reported. The subjects had histories of behavioral parasomnias as well as positive family histories of parasomnia. A 27 year-old man with a history of sexual behavior during sleep was reported. His sleep history disclosed sleepwalking (SW) since 9 years of age. He also developed episodes of highly disruptive and violent nocturnal behavior with dream enactment at age 20 years, which often resulted in physical injuries either to himself or his wife and infant. His wife also reported episodes of amnestic sexual behavior that began 4 years before referral. During the episodes, the patient typically procured his wife, achieving complete sexual intercourse with total amnesia. Physical and neurological diagnostic workups were unremarkable. Family history disclosed sleepwalking in his brother. He was put on 2mg/day of bedtime clonazepam with a remarkable clinical improvement. This case involves either the combination of violent and non-violent sleepwalking with SBS, or the superimposition of presumed REM sleep behavior disorder (RBD) on top of preexisting SW in a man who also developed SBS in adulthood. Thus, this is a case report of probable parasomnia overlap syndrome.

Adult↗
PubMed1998

[Kidney transplantation in patients with type I and type II diabetes mellitus].

A total of 618 patients with end-stage renal disease received kidney transplants between 1980 and September 1996. Twenty eight of them were diabetics. Better results were achieved for type 1 diabetic patients than for type 2 (mortality: 5.9% vs 27.3%; functioning graft: 88.2% vs 72.7%). The morbility was also higher in those patients (infections: 81.8% vs 29.4%; vascular complications: 45.5% vs 17.6%). Actuarial patient and graft survival were lower for type 2 than for non diabetic patients. For type 1 diabetics the results are similar to those for non diabetics. Better results can probably be achieved by restricting the selection criteria. The decision to transplant or maintain on dialysis should be made on a case by case basis.

Adult↗
PubMed1998

[Accidents with fireworks. Hand lesions in children].

We report our experience in the treatment and rehabilitation of traumatic hand lesions due to firework explosions. From January 1990 to January 1997, eight patients were evaluated according to the same protocol. All patients are from rural areas, males were predominant (87%) and ten years-old were the prevalent age group. The lesions were unilateral in 87.5% of all cases, with a special incidence in the left hand (55%) and the finger was the most affected, index (25.5%). Amputation was the most frequent residual lesion (75%), followed by debridement (62.5%) and changes intactil sensitivity (50%). Early surgery and rehabilitation are the fundamental aspects for the successful treatment and functional prognosis of these patients, but prevention is still the best way to stop the occurrence of these cases.

Blast Injuries↗
PubMed1998

Childhood cutaneous mucinosis.

A case of childhood cutaneous mucinosis is described. This is a clinical condition that is rarely seen and has only recently been included in the group of primary mucinosis.

Adolescent↗
PubMed1996

Lipid peroxidation in mitochondrial inner membranes. I. An integrative kinetic model.

An integrative mathematical model was developed to obtain an overall picture of lipid hydroperoxide metabolism in the mitochondrial inner membrane and surrounding matrix environment. The model explicitly considers an aqueous and a membrane phase, integrates a wide set of experimental data, and unsupported assumptions were minimized. The following biochemical processes were considered: the classic reactional scheme of lipid peroxidation; antioxidant and pro-oxidant effects of vitamin E; pro-oxidant effects of iron; action of phospholipase A2, glutathione-dependent peroxidases, glutathione reductase and superoxide dismutase; production of superoxide radicals by the mitochondrial respiratory chain; oxidative damage to proteins and DNA. Steady-state fluxes and concentrations as well as half-lives and mean displacements for the main metabolites were calculated. A picture of lipid hydroperoxide physiological metabolism in mitochondria in vivo showing the main pathways is presented. The main results are: (a) perhydroxyl radical is the main initiation agent of lipid peroxidation (with a flux of 10(-7)MS-1); (b) vitamin E efficiently inhibits lipid peroxidation keeping the amplification (kinetic chain length) of lipid peroxidation at low values (approximately equal to 10); (c) only a very minor fraction of lipid hydroperoxides escapes reduction via glutathione-dependent peroxidases; (d) oxidized glutathione is produced mainly from the reduction of hydrogen peroxide and not from the reduction of lipid hydroperoxides.

Cardiolipins↗
PubMed1992

[Skin pathology in kidney transplant recipients].

Since 1990, 82 unselected renal allograft recipients were evaluated in order to establish the incidence of cutaneous disorders. This pathology was related to the period of immunosuppression according to time of transplantation: 0-3 months; 3-12 months; 12-36 months and beyond 36 months. Most of them were on triple immunosuppression (cyclosporine A, azathioprine and prednisone)--(51); Twenty-two also associated anti-timocyte globulin five days after transplantation; 7 were on Azathioprine and Prednisone and two of them associated Cyclosporine with Prednisone. Iatrogenic manifestations were the most common (80.5%) followed by infections in 63.4% and pre-malignant and malignant cutaneous lesions in 13.4%, other types of manifestations were found in 20.7% of patients. A significant incidence of pre-malignant and malignant lesions confirms other reports, making a dermatological surveillance advisable.

Adolescent↗
PubMed1988

Osteoglophonic dysplasia: a new case.

A new case of osteoglophonic dysplasia is described in a Portuguese boy. The clinical and radiographic features are similar to the five previously described cases. The boy died suddenly at 10 months of age.

Abnormalities, Multiple↗
PubMed1985

[Hypertensive intracerebral hematomas: apropos of 50 cases].

Fifty cases of supratentorial intracerebral hematomas associated with hypertension are analyzed. The best treatment of the intracerebral hematomas is not settled. The authors reviewed and analyzed the literature and they suggest that the small hematomas should be managed conservatively as well as those patients in deep coma. The subcortical hematomas usually improve with surgical removal. In the deep ganglionic type the initial treatment is clinical. If no improvement occurs the hematoma should be removed with microsurgery technique.

Adult↗
PubMed1979

Cooperia connochaeti sp. nov. (Nematoda, Trichostrongylidae) from the blue wildebeest, Connochaetes taurinus (Burchell, 1823).

A new species of nematode. Cooperia connochaeti, was collected from cross-bred blue and black wildebeest at Krugersdorp (Transvaal), blue wildebeest Connochaetes taurinus (Burchell, 1823) from the Kruger National Park (Transvaal) and Lake Xhau (Botswana), as well as from impala Aepyceros melampus (Lichtenstein, 1812) at Malelane (Transvaal) and Pafuri (Kruger National Park). These nematodes are smaller than Cooperia pectinata Ransom, 1907, and their spicules, which are bifid in the distal third, are shorter (145-166 micron) than those of C. pectinata (240-280 micron). In addition, the lateral branches of the dorsal ray of C. connochaeti are directed ventrally and slightly anteriorly, while those of C. pectinata are directed posteriorly.

Animals↗
PubMed1977

[Asplenic syndrome].

Explore the source record for details and available documents.

Abnormalities, Multiple↗
PubMedDate not supplied

[Asphyxiating thoracic dystrophy: a report of 3 cases]

OBJECTIVE: To drive pediatrician's attention to a syndrome wwich has as its typical clinical presentation a thoracic cage abnormality which evolves to respiratory distress and death during the first two years of life.METHODS: We describe three cases of patients with clinical and radiographic findings characteristic of asphyxiating thoracic dystrophy (Jeune's Syndrome): short and narrow thoracic cage and abnormal development of the ribs. A brief review of the literature on the subject is also included.RESULTS: The three patients are older then two years of age. They did not present life threatening pulmonary complication nor respiratory distress, in contrast to most of the cases reported in the literature.CONCLUSIONS: Even though the number of occurrences of this syndrome is quite low, it must be consider when conducting a differential diagnostic related to thoracic cage abnormalities. It is important to emphasize the degree of variability of the pulmonary lesions and the progress of the disease. However, most articles on the subject point to a grim outcome.

Journal Article↗
PubMedDate not supplied

Two recent cases of tertiary syphilis.

Tertiary syphilis is now a rare disease in Europe, mainly as a result of occasional antibiotherapy for concomitant infections. However early syphilis is rising in USA and Germany, and it is necessary to maintain an high level of knowledge and suspicion to achieve a diagnosis in the tertiary stage of the disease. In this report two patients with benign tertiary syphilis are described. The first one is a 55-year-old female with erythemato-violaceous annular scaling plaques on the right buttock and scapula and on both thighs, which had a negative and then a low VDRL titer. The second case is a 33-year-old mentally handicapped female with erythematous plaques, with psoriasiform scaling in the trunk and well defined crusted ulcers on the face, which also had negative VDRL. Biopsy of the skin lesions revealed plasmocytic infiltrate with endothelial swelling without granulomas and with negative silver stains in both patients. The investigation for cardiovascular and neurological involvement was negative in both patients. Diagnosis of tertiary syphilis can be difficult as clinical pictures can be misleading, similar to other granulomatous diseases, and serological titers can be low or negative. We recall the necessity of ruling out neurological and cardiac involvement in this stage of syphilis. These cases are reported as a reminder of the possibility of syphilis, so that new cases are not misdiagnosed and mistreated as other diseases.

Adult↗
PubMedDate not supplied

[Potentially treatable subacute forms of infection due to the HTLV-1].

INTRODUCTION: Tropical spastic paraparesis due to HTLV-I virus is diagnosed at very advanced stages, when there is spinal atrophy present and so only symptomatic treatment can be given. Early diagnosis of HTLV-I infection in unusual syndromes and the use of corticosteroids may help to slow the development of the disease. CLINICAL CASES: We describe two Brazilian patients who developed symptoms due to HTLV-I present for less than one year: subacute myelopathy with a sensory level and an ataxic pyramidal syndrome associated with axonal neuropathy, which partly improved after treatment with corticosteroids. RESULTS: A 50 year old woman presented with progressive paraparesis following pain, cramps, feeling that her legs had 'gone to sleep' and sphincter dysfunction over the previous eleven months. Spinal MR showed a diffuse spinal hypersignal at D2. The 60 year old man had developed an ataxic syndrome and axonal polyneuropathy over the previous ten months. In both patients the anti-HTLV antibodies in blood and CSF were positive on ELISA as later confirmed by Western-blot. Thorough biochemical study ruled out other infectious etiologies. Both patients were treated with corticosteroids (i.v. methylprednisolone and oral prednisone respectively) and their symptoms improved, particularly the joint pains, ataxia and the 'gone to sleep' sensation of the legs. CONCLUSIONS: The ataxic syndrome and myelopathy due to HTLV-I, when these have been diagnosed early, may benefit from corticosteroid treatment and progression of the disorder be prevented. The myelitic phase of HTLV-I infection is associated with diffuse myelopathy, which was unusually seen in our first patient on spinal MR.

Anti-Inflammatory Agents↗
PubMedDate not supplied

[Prevalence of cutaneous lesions in Freixo de Espada à Cinta].

Incidence or prevalence studies on cutaneous lesions in general populations are not available. The community observed by the authors (Freixo de Espada à Cinta, North-Eastern Portugal) is relatively closed. A pre-tested questionnaire for socio-demographic and clinical information was used and a physical observation was conducted in January and February 1994 by the Dermatology Team of Santo António General Hospital, Oporto. The analysis was supported by independent tests (Pearson and Fisher chi 2, Student-t, Mann-Whitney and Kruskall-Wallis). The Spearman correlation coefficient was also used. The results indicated that 51.9% of 1000 subjects analysed were in phototype III. Concerning specific pathologies, the following percentages were observed: melanocytic nevi 81.2; hemangiomas 26.5; androgenetic alopecia 20.5; deshydrotic eczema 12.7; seborrheic keratosis 11; solar keratosis 9.6; acne vulgaris 9.5; seborrheic dermatitis 6.9; superficial mycosis 6.4; other dermatitis 5.5; vascular spiders 4.4; vulgar psoriasis 1.9; vulgar warts 1.5; pediculosis and scabiosis 1.2.; herpes simplex 0.9; impetigo 0.7; tumours (neoplasias) 0.7; dysplastic nevi 0.6; urticaria 0.3. More than nine nevi were counted in 50% of the subjects observed. A difference was observed (p < 0.05) concerning the presence of nevi, mycosis, hemangiomas, non-specific dermatitis, vascular spider and solar keratosis according to sex. The females had more nevi in number than males (Mann-Whitney, p = 0.03). According to age there was a difference concerning the presence of nevi, superficial mycosis, deshydrotic eczema, seborrheic dermatitis, acne, psoriasis, tumours, hemangiomas, non-specific dermatitis, vascular spider, solar keratosis (with linear augmentation by age) and seborrheic keratosis. Nevi increased with ageing (Rs = 0.10 p < 0.001) and a greater number were observed in age groups 0-9 and 60 or more years. Acne was observed in 9.4% of the females and 9.7% of the males, 46.2% in the 15-29 year-old age group. This study indicated that the population had a mean of nine nevi. Psoriasis was similar to that mentioned in other studies: about 1% in the United States of America. Atopic dermatitis (5.5%) is below the values for the northern population (> = 15%), but above that indicated for the English and American population. Nevertheless, the values of the present study were higher than those in the latter populations, when children until seven years old were considered. The Freixo de Espada à Cinta population above 60 years had solar keratosis in 30.6%, a value three times higher than the previous decade (10.9%); reference values were not found. Contrary to the literature, an association was not established between phototype and solar keratosis. Cutaneous tumours were observed in 0.7% of the cases.

Adolescent↗
PubMedDate not supplied

Cutaneous necrobiotic xanthogranuloma (NXG)--successfully treated with low dose chlorambucil.

We report a case of necrobiotic xanthogranuloma in a 51 year-old white male patient presenting with a 6-year history of multiple indurated violaceous nodules and plaques involving the eyelids, trunk and extremities. He had an associated paraproteinemia (Ig G lambda), elevated sedimentation rate, cryoglobulinemia and hypocomplementemia. No extracutaneous involvement was detected. He was successfully treated with chlorambucil (2 mg/d for 7 months), leading to disappearance of all skin lesions.

Adult↗
PubMedDate not supplied

[Diabetes mellitus after renal transplant].

UNLABELLED: Posttransplant Diabetes Mellitus (PTDM) has traditionally been attributed to therapy with steroids, however with the introduction of Cyclosporine (cya) into clinical practice, an increase in the incidence of PTDM was noted. We studied the prevalence of PTDM in Renal transplant recipients and its clinical characteristics. MATERIALS AND METHODS: 355 patients were submitted to a renal transplant between 30/06/80 and 31/12/92. After stabilization of the doses of the immunosuppressive therapy we considered diabetic patients those with fasting glycemic values > or = 140 mg/dl and those with glycemic values between 100-140 mg/dl were given to an oral glucose tolerance test (WHO criteria 1985). RESULTS: Posttransplant diabetes mellitus occurred in 28 patients (7.9%), 11 females with a mean age of 53.36 +/- 12.75 years and 17 males with a mean age of 51.05 +/- 10.60 years. DISCUSSION: Due to the great prevalence of alterations in glucose tolerance and their adverse effects on the cardio-vascular system, we think that all renal transplant recipients should be screened.

Adult↗